Individual
JENNIFER L TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
611 E MAIN ST, HART, MI 49420
(231) 873-5675
(231) 873-1825
Mailing address
PO BOX 1848, MUSKEGON, MI 49443-1848
(231) 727-5211
(231) 727-4571
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601003148
MI
Other
Enumeration date
05/17/2006
Last updated
06/06/2018
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